Managed Care SLP

As the second appointee towards completing the Session Long Project, please answer the following in your own words 1. What is accreditation? 2. Why is it important? 3. What organizations accredit managed manage organizations in the U.S.? 4. What is involved in the accreditation process? (In other words, what do they look at? Do they make site visits? 5. What is the accreditation status of your health care provider organization (hospital, clinic, treatment facility, and so forth)? If you are not covered infra a managed care plan, identify any managed care plan and explain its accreditation status.Limit your responses to 1-2 pages. Be sure to properly cite all references. The following sack up sites will help you complete this assignment Glossary of managed care terms What is accreditation? National Committee for Quality Assurance (NCQA) What is NCQA & Why is accreditation important? pin electric charge on Accreditation of Healthcare Organizations (managed care accreditation info rmation). http//www.jointcommission.org/AboutUs/joint_commission_facts.htm http//www.jointcommission.org/HTBAC/benefits_accreditation.htm JCAHO Quality Check to look up accreditation status of facilities www.qualitycheck.org/consumer/searchQCR.aspx URAC http//www.urac.org/consumer_how.asp Frequently Asked Questions about Accreditationhttp//web.ncqa.org/tabid/65/Default.aspxhttp//www.jointcommission.org/AccreditationPrograms/Networks/mco_facts.htmhttp//www.urac.org/healthcare/accreditation/Other resources to help with the assignment http//www.ncqa.org/communications/news/clas.htmWhat is accreditation?Accreditation is a procedure in which a neutral organization reviews the standards of care provided by the company. This process would make sure that the business performed by the company is done as per the standards laid down.Why is it important?The public is ensured that the standards of quality is maintained whilst providing medical care There is some amount of sinewy competition in the market There is a reductions in risks Patient safety levels are improved Negligence is reduced Good practices are supportThe process of reviewing the operational activities of the company is performed Staff recruitment and development may be encouraged The company may be brought into Medicare certification without undergoing a assorted review process Insurers and third parties would automatically recognize the company is accreditation is present Some states require that a company achieve accreditation so that it could play off the regulatory bodys requirements Structure and functions in the organization is maintained What organizations accredit managed care organizations in the U.S.? Accreditation of managed care organizations in the US is brought about by received accreditation organizations such as the URAC, Joint Commission and the NCQA. However, an accreditation organization would be accrediting different types of healthcare organizations. The organization may be accredi ting all the services of the company or a particular service. Once the company meets certain standards imposed by the accreditations organization, it would receive certification.What is involved in the accreditation process? (In other words, what do they look at? Do they make site visits?Before an organization applies for accreditation, it would have to conduct a gross(a) self-check by ensuring it meets with the standards provided by the accreditation organization. At least some changes would be required. The entire process of accreditation should be taking about 4 to 6 months. An application for accreditation is submitted by the healthcare organization. The reviewers at the accreditation organization conduct a thorough review of the details in the application. This may be an examination of the certificates or an onsite review. Changes may be required to meet the standards. Depending on the ability of the company to meet these standards, accreditation is provided.What is the accred itation status of your health care provider organization (hospital, clinic, treatment facility, etc.)? If you are not covered under a managed care plan, identify any managed care plan and explain its accreditation status.The company that I work in is accredited by some of the top accreditation organizations in the US. I do subscribe to a managed care plan, which has been accredited by the Joint Commission. The Joint Commission looks into several standards provided by the HMO including performance, health promotion, disease prevention, utilization, management of information, education process, HR management, etc. The Joint Commission interviews the administrative procedures concerned with the plan and the various HR. The documents are constantly reviewed and the ability to meet with the standards is determined.ReferencesNCQA. About NCQA. 2007. NCQA. 21 Jul. 2007 http//web.ncqa.org/tabid/65/Default.aspx The Joint Commission. Benefits of Joint Commission Accreditation. 2007. Joint Comm ission. 21 Jul. 2007 http//www.jointcommission.org/HTBAC/benefits_accreditation.htmThe Joint Commission. Facts about The Joint Commission. 2007. Joint Commission. 21 Jul. 2007 http//www.jointcommission.org/AboutUs/joint_commission_facts.htmThe Joint Commission. Facts about Managed Care Organization Accreditation. 2007. Joint Commission. 21 Jul. 2007URAC. full general Questions About URAC Accreditation. 2007. URAC. 21 Jul. 2007http//www.urac.org/healthcare/accreditation/